Provider Demographics
NPI:1518541358
Name:KRONTZ, JOHN ANDREW
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ANDREW
Last Name:KRONTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-2432
Mailing Address - Country:US
Mailing Address - Phone:330-733-9996
Mailing Address - Fax:
Practice Address - Street 1:2420 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-2432
Practice Address - Country:US
Practice Address - Phone:330-733-9996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist